Breast Cancer Disparities

The main purpose of Breast Cancer Awareness Month every year in October is to bring down the death rates of this disease by promoting early detection. This practice was first founded in 1985 by the American Cancer Society and Imperial Chemical Industries as a way to encourage regular mammograms. Experts in the medical field advise the general public to self-examine their breasts every month through a three-step process, and get clinical examinations once every three years for women aged 20 to 39, and annually for women over 40. Around 40% of breast cancer cases are first detected through self-examination.

Although Breast Cancer Awareness Month has made leaps and bounds in increasing public knowledge of this disease from its original obscurity in the 19th and early 20th century, there still exist some barriers towards lowering the preventable death toll.

Because the world we currently live in is founded on systemic inequalities, the ways in which medical issues affect the general population are influenced by factors beyond the purely biological. Throughout the world, both race and class affect an individual’s ability to access healthcare, with historically oppressed minorities more likely to succumb to preventable deaths.

In the case of breast cancer, American researchers in Mount Sinai Hospital published a study this year stating that although more white women get breast cancer than black women in the US, black women are 40% more likely to die of breast cancer than their white counterparts. One of the factors contributing to this disparity was the stage at which the cancer was detected. Another was the rate at which black women developed metastases, the spread of cancer to other parts of the body.

Another 2021 study in America by Doctors Sparano and Brawley showed that women of African descent have higher rates of taxane-induced neuropathy, a biological factor influencing cancer death rates. The doctors stated that for those diagnosed with cancer, “both racial and ethnic minority groups have worse outcomes compared with non-Hispanic Whites”, with breast cancer death rates 71% higher for black people and 14% higher for Hispanic people. They emphasized that these disparities were largely driven by socioeconomic factors such as less access to quality care and greater comorbidity burdens.

Undocumented immigrants face an even higher risk of breast cancer death. This is because their illegal status in their countries of residence bars them from accessing healthcare regardless of economic means (though they are also likely to be economically disadvantaged).

Tackling these disparities is not going to be easy: addressing inter-sectional inequalities requires the cooperation of many facets of government and society.

Firstly, conversations must be had amongst private citizens to educate each other on race and class inequalities. For a problem to be solved, it must first be acknowledged. Secondly, systemic racism in healthcare should be thoroughly researched to find long-term, holistic solutions. In Canada, research into racial disparities in healthcare is gaining traction, demonstrated through the efforts of projects such as the Interdisciplinary Centre for Black Health, and the continuous community-based programs of the Public Health Agency of Canada. The addressing of global socioeconomic disparities is a continuous, intergovernmental, multigenerational process.

Lastly, the breast cancer survivor and health activist Hil Moss called attention in her recent article to the increased corporatization of Breast Cancer Awareness Month, with some companies using the pink ribbon as a sales tactic and donating very little of their proceeds to research centres and breast cancer initiatives. She cautions her readers against surface-level purchases, urging them to inquire as to the percentage being donated by each corporation claiming to support the cause. She also encourages her readers to remember that the victims of breast cancer are not some abstract statistic: “If someone in y our life is affected by breast cancer, check in on them this month. See how they are faring with the constant reminders.”